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Market access for medical technologies in Estonia

A brief overview of key market access pathways and challenges for medical devices, in-vitro diagnostic tests in Estonia


Key topics

There is only one key theme describing market access for medical technologies in Estonia: 

  • Reimbursement: payment via the mix of DRG and fee-for-service mechanisms


Hospital services are reimbursed via a mix of DRG, fee-for- service and per diem payment mechanisms. The per diem payment mechanism covers basic examination, diagnosis and treatment planning, laboratory tests, and hospital stay, while the medical procedure itself is covered via the DRG (70%) and the fee-for-service (30%) payment mechanisms. Reimbursed services and tariffs for both payment mechanisms are defined in the Estonian List of reimbursed services.

If the cost of the case is too high or too low (above the higher DRG limit or below the lower DRG limit), it will be covered completely via fee-for-service. Consequently, there is a list of procedures (related to longer than average length of stay or using high cost devices) that are exempted from the DRG reimbursement and are solely reimbursed via the fee-for-service mechanism.

Estonia shares the DRG system (NordDRG) with Nordic countries, including Sweden, Finland and Norway. DRGs are determined by the combination of a procedure code (NCSP) and a diagnosis code (ICD-10). The Estonian version of the NCSP nomenclature and the Estonian version of the NordDRG system are maintained by the Estonian Health Insurance Fund (EHIF) and are released annually.


Specifics for IVD tests

IVD tests provided in outpatient specialist settings are reimbursed on a fee-for-service basis via the Estonian List of reimbursed services.

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